Friday, July 06, 2012

International Groups Issue Statement on Diabetes in Older Adults

A new position paper by 3 international groups addresses 8 domains of interest for older adults with diabetes: hypoglycemia, therapy, diabetes in the nursing home, influence of comorbidities, glucose targets, family/caretaker perspectives, diabetes education, and patient safety. The groups wrote the position paper because "most international clinical diabetes guidelines fail to address issues that are common in the elderly, including frailty, functional limitation, mental health changes, and increasing dependency," says an article by Medscape Medical News.

The authors, from the International Association of Gerontology and Geriatrics, European Diabetes Working Party for Older People, and International Task Force of Experts in Diabetes, identified major research areas that need to be explored, including:

the use of exercise, nutrition, and glucose-lowering therapies in the effective management of type 2 diabetes in older people;

practical community-based interventions to reduce hospitalization;

methods to decrease hypoglycemia rates in various clinical settings;

health economic evaluations of metabolic treatment;

interventions to delay/prevent diabetes-related complications that are important in older age, such as cognitive impairment and functional dependence; and

development of technical devices that help to maintain autonomy and safety for older people with diabetes.

The authors note that although functional status and well-being are a major focus of experts in geriatric diabetes, the issue of glucose targets is a fundamental one that needs to be addressed.

The position paper is published in the July issue of Journal of the American Medical Directors Association.